Item O2BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: August 16, 2006
Bulk Item: Yes X No
Division: Countv Administration
Department: County Administration
Staff Contact Person: T. Willi
AGENDA ITEM WORDING:
Approval to reimburse County Administrator for 12 months of life insurance premium and to approve
of monthly reimbursement for future premium payments.
ITEM BACKGROUND:
The employment contract with the County Administrator requires the County to provide to the
Administrator a $300,000 life insurance policy. The policy, procured and owned by the Administrator
was issued on August 31, 2005 and the annual premium is $749.04, paid in monthly installments of
$62.42.
PREVIOUS RELEVANT BOCC ACTION:
CONTRACT/AGREEMENT CHANGES:
STAFF RECOMMENDATIONS:
Approval of reimbursement for insurance premiums to the County Administrator of $749.04
and to allow for future monthly reimbursements of $62.42.
TOTAL COST: $749.04
COST TO COUNTY: $749.04
BUDGETED: Yes X No
SOURCE OF FUNDS:
REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year
APPROVED BY: County Atty OMB/Purchasing Risk Management
DIVISION DIRECTOR APPROVAL:
DOCUMENTATION: Included
DISPOSITION:
Revised 2/05
J Pigaug I wim
(TYPE NAME HERE)
X Not Required
AGENDA ITEM #
Thank you for choosing Primerica Life Insurance Company. This Fact Sheet
provides important information about your insurance coverage as of
08/19/2005, as well as identification and reference cards.
As always, if you have any questions about your policy, please do not
hesitate to call our toll -free Client Services line.
Policyowner:
Policy Number:
Policy Date:
THOMAS J WILLI
0433511601
09/15/2005
Primary Insured: THOMAS J WILLI
Spouse Rider(s):
Child Rider:
Other Benefits: INCREASING BENEFIT RIDER ON INSURED (10%)
WAIVER OF PREMIUM
Current Premium Amount: * $62.42
CURRENT
FACE
AMOUNT(S) *
$300,000 *
Payment Method: MONTHLY PRE -AUTHORIZED BANK DRAFT DRAFT DAY 15
* Please see your policy for information about your premiums and coverage.
Amounts shown include all riders.
REMINDER CARD
PRIMERICA LIFE INSURANCE COMPANY
As of 08/19/2005:
Policy Number: 0433511601
Policyowner:
THOMAS J WILLI
Current Premium
Amount: $62.42
Payment Method:
MONTHLY BANK DRAFT
Payment Due Date: 15th
REMINDER CARD
PRIMERICA LIFE INSURANCE COMPANY
As of 08/19/2005:
Policy Number: 0433511601
Policyowner:
THOMAS J WILLI
Current Premium
Amount: $62.42
Payment Method:
MONTHLY BANK DRAFT
Payment Due Date: 15th